Reflections of a Pharmacy Practice Resident

ADS – Complications of Liver Disease

This was a complicated but interesting lecture on the complications of liver disease. My co-residents Alex and Nina did a great job explaining all the different sequale of liver disease! Below is my summary of the conditions discussed.

Child-Pugh Classification is based on encephalopahy, ascites, bilirubin, albumin and PTT – the higher the score the worse the grade (e.g. Class A, B, C) the higher the one-year survival in non-surgical patients.

Pre-primary prophylaxis (have cirrhosis but no varices): no b-blockers, repeat esophagogastrduodenoscopy (EGD) in 3 years

Primary prophylaxis (no hx of history, small varices): shoulde use non-selective b-blockers in pts who are at high risk for bleeding, can use in low risk too. Rpt EGD in 2 yrs in those who do not take b-blockers.

Primary prophylaxis (medium/large varices): Non-selective B-blockers or endoscopic variceal ligation are recommended in patients with high risk for bleeding, while B-blockers preferred first-line in patients not high risk for bleeding